An estimated 36 million US citizens have impaired hearing, but only one in five has had a hearing test. As noted by a recent NIDCD Working Group, In the US there are no readily accessible low-cost hearing screening programs. The authors of this proposal, in collaboration with scientists from Indiana University & VU University Medical Center of Amsterdam, have developed and validated a low-cost screening test for hearing disability, for administration by telephone. This test is based on one that has been available for the past seven years in the Netherlands, versions of which are now in use in the UK, Australia, France, and Germany, and are being developed in several other countries. Validity of the US test has been demonstrated in studies conducted at the Indiana University Hearing Clinic and in cooperation with the Veterans Administration. This project will determine the kind and extent of marketing needed to insure substantial usage of the test and the kind and extent of follow-up needed to insure that those who fail it seek professional hearing services. In Year 1 the test will be launched in two metropolitan areas. In one it will be mainly publicized through mass media; in the other through presentations to local organizations. Interested persons will be directed to a website, where the test will be explained, and they will be invited t take the test for a fee of $4.00. The fee will support the cost of administering the test to right nd left ears, the collection and analysis of demographic information from each person tested, the cost of follow-up, and the cost of publicizing the test either through mass media, such as the AARP Magazine and local newspapers, radio and television; or through presentations to service organizations such as the Lions, Kiwanis, Rotary, retirement homes, labor unions, and religious organizations. Net program income during this project will be devoted to the expansion of the areas in which the test is available and the refinement of methods of publicizing the test. Based on Year 1 results, marketing plans will be implemented in additional metropolitan areas in Year 2. If the US response rates are similar to those reported in the Netherlands and the UK, between 1.5 and 2.0 million persons could eventually be tested annually in the US. The two differences between this test and the large number of free tests advertised by hearing aid dealers and manufacturers are that (1) it has been proven to be a valid screening test in extensive clinical testing and (2) it is made available by a consortium of two universities and a test- development company, none of which have any financial connections to the hearing aid industry and thus have no conflict of interest in the test outcomes.